Monitoring neonates for ototoxicity

Int J Audiol. 2018 Sep;57(sup4):S41-S48. doi: 10.1080/14992027.2017.1339130. Epub 2017 Jun 22.


Objectives: Neonates admitted to the neonatal intensive care unit (NICU) are at greater risk of permanent hearing loss compared to infants in well mother and baby units. Several factors have been associated with this increased prevalence of hearing loss, including congenital infections (e.g. cytomegalovirus or syphilis), ototoxic drugs (such as aminoglycoside or glycopeptide antibiotics), low birth weight, hypoxia and length of stay. The aetiology of this increased prevalence of hearing loss remains poorly understood.

Design: Here we review current practice and discuss the feasibility of designing improved ototoxicity screening and monitoring protocols to better identify acquired, drug-induced hearing loss in NICU neonates.

Study sample: A review of published literature.

Conclusions: We conclude that current audiological screening or monitoring protocols for neonates are not designed to adequately detect early onset of ototoxicity. This paper offers a detailed review of evidence-based research, and offers recommendations for developing and implementing an ototoxicity monitoring protocol for young infants, before and after discharge from the hospital.

Keywords: Newborn hearing screening; anatomy and physiology; conditions/pathology/disorders; paediatric.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Age Factors
  • Child, Preschool
  • Dose-Response Relationship, Drug
  • Drug Interactions
  • Drug Monitoring / methods*
  • Early Diagnosis
  • Hearing / drug effects*
  • Hearing Loss / chemically induced*
  • Hearing Loss / diagnosis
  • Hearing Loss / physiopathology
  • Hearing Loss / therapy
  • Hearing Tests*
  • Humans
  • Infant
  • Infant, Newborn
  • Intensive Care Units, Neonatal
  • Predictive Value of Tests
  • Risk Assessment
  • Risk Factors